Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $173.27 / $200.72	Facility	26	$100.00	$173.27	$200.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $170.00 / $551.65	Professional	26	$100.00	$170.00	$551.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.34 / $112.98 / $154.05	Professional	26	$81.34	$112.98	$154.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.89 / $159.76 / $261.72	Professional	26	$98.89	$159.76	$261.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.00 / $173.09 / $618.48	Professional	26	$119.00	$173.09	$618.48
Hally Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $136.86 / $140.63 / $148.34	Professional	26	$136.86	$140.63	$148.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.10 / $145.22 / $242.40	Professional	26	$110.10	$145.22	$242.40